Enhancing the communication development of toddlers with autism spectrum disorders

Mahoney and Perales (2003) reported on intervention outcomes for 20 young children with ASD (80% of whom were under three years of age at enrollment). The authors categorized their program as “relationship-focused” intervention. Specifically, parents and children met individually with early intervention specialists for 1 hour per week, either in a center-based setting or in the child’s home. On average, families participated in 31 individual sessions spanning an average time period of 11 months. The intervention objectives were selected based on an individualized assessment of the child and family. Objectives for the child were drawn from the areas of cognition (e.g., social play, initiation, problem solving), communication (joint activity, joint attention, vocalization, intentional communication, conversation), social-emotional functioning (e.g., attachment, empathy, self-regulation), and motivation (e.g., interest, persistence, enjoyment). Parents learned responsive teaching strategies to incorporate into interactions with their children during daily routines. The strategies included five components: reciprocity, contingency, shared control, affect, and match.
Comparison of pre-intervention to post-intervention measures revealed significant changes in parent behaviors related to responsive teaching as well as child behaviors related to social interaction (including joint attention), temperament, and social-emotional functioning (Mahoney & Perales, 2003). Further, although the parents’ initial level of responsiveness was not significantly associated with gains in their children’s social interactive functioning across the intervention period, the changes in parental responsiveness from pre- to post-intervention accounted for 25% of the variance in changes in the child’s social interactive behavior.
These two investigations are limited methodologically by a lack of comparison groups or other experimental controls. Nevertheless, the demonstrated progress of the young children enrolled in each of these programs is encouraging. The programs are also instructive examples for the purposes of this article, because each program was designed for contexts that are natural for toddlers with a focus on child-directed early intervention.
The intervention programs described above incorporate a variety of strategies that have been identified in the literature as beneficial to the development of language and communication in young children with ASD or other developmental disabilities. Among the many strategies highlighted throughout the literature are: talking about the child’s current focus of attention (Siller & Sigman, 2002; Watson, 1998; Yoder et al., 1993), engaging in motivating activities that are meaningful to the child and that are within the child’s zone of proximal development (Prizant, Wetherby, & Rydell, 2000), increasing the child’s opportunities to communicate with others through requesting and commenting, and providing contingent responses to the child’s previous verbal or nonverbal communicative acts (Warren et al., 1993; Yoder & Warren, 1998). The remainder of this section will focus on these strategies for facilitating prelinguistic communication and the potential relationship to later language development.